Scientific consensus

The elements in the decision to vaccinate were not clear cut and not generally agreed upon. It required discussion with key agencies (State HD, CDC) to reach a consensus that could be defended in public and with the local health care provider community. The more recent ACIP recommendations in MMWR of 2000 are more explicit about vaccination criteria.

Parental anxiety

The death of case 2 created intense concern among parents about safety at school. Part of the anxiety stemmed from erroneous information on spread of the disease and transmissibility via water, air, surfaces. There was considerable pressure to prophylax everyone (how can you withhold antibiotics to my child) and later on to vaccinate as widely as possible. Contradictory advise from local physicians was a problem and dealt with by explicitly stating the vaccination criteria (of high risk group) and allowing those who were unconvinced to consult their private doctor.

Other questions dealt with the effect and side effects of prophylaxis and vaccination, and with the legal mandate to vaccinate or to withhold vaccination.